Prognostic Value of Syncope in the Presentation of Pulmonary Embolism

Jiménez, D.; Díaz, G.; Valle, M.; Martí, D.; Escobar, C.; Vidal, R.; Picher, J.; Sueiro, A.

doi:10.1016/S1579-2129(06)60246-2

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 41. Issue 7.

Pages 385-388 (July 2005)

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Pages 385-388 (July 2005)

Original Articles

DOI: 10.1016/S1579-2129(06)60246-2

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Prognostic Value of Syncope in the Presentation of Pulmonary Embolism

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D. Jiméneza,

Corresponding author

djc_69_98@yahoo.com

Correspondence: Dr. D. Jiménez Castro. Servicio de Neumología. Hospital Ramón y Cajal. Departamento de Medicina. Universidad de Alcalá de Henares. Ctra. de Colmenar, Km 9,100. 28034 Madrid. España

, G. Díazb, M. Vallea, D. Martíc, C. Escobarc, R. Vidala, J. Pichera, A. Sueiroa

a Servicio de Neumología, Hospital Ramón y Cajal, Madrid, Spain

b Servicio de Neumología, Hospital de la Zarzuela, Madrid, Spain

c Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, Spain

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Objective

Although the prognostic value of syncope has not been specifically addressed, it has generally been considered an indicator of poor prognosis in pulmonary embolism. The objective of this study was to carry out a prospective evaluation of the risk of recurrence and/or death in patients with pulmonary embolism that presents with syncope.

Patients and methods

A total of 168 patients had a confirmed diagnosis of pulmonary embolism. Twelve were lost to follow up and did not enter statistical analysis. The mean follow-up period was 5 months.

Results

The prevalence of syncope in the patients studied was 22%. Of the 34 patients who presented syncope, objectively confirmed recurrence occurred in 2 (5.9%). In the patients who did not present syncope, recurrence was confirmed in 8 (6.6%; P = .8). Death occurred in 2 patients (5.9%) from the group presenting syncope and 15 (12.3%) from the remaining patients in the series (P = .4). The relative risk of recurrence and/or death associated with presentation of syncope was 0.5 (95% confidence interval, 0.2-1.8). A similar risk was obtained following adjustment for the presence or absence of cancer or deep vein thrombosis.

Conclusions

Patients with pulmonary embolism that presents with syncope do not have an increased risk of recurrence and/or death.

Key Words:

Pulmonary embolism

Syncope

Recurrences

Death

Objetivo

Clásicamente se ha considerado que el síncope es un factor de mal pronóstico en la tromboembolia de pulmón (TEP), aunque esta cuestión no se ha estudiado de forma específica. El objetivo de nuestro estudio ha sido evaluar de forma prospectiva el riesgo de recurrencia y/o muerte en pacientes con síncope como forma de presentación.

Pacientes y métodos

Estudiamos a 168 pacientes con diagnóstico confirmado de TEP durante una media de 5 meses.

Resultados

La prevalencia de síncope en la serie estudiada fue de un 22%. Entre los 34 pacientes que sufrieron un síncope, se produjo una recurrencia objetivamente confirmada en 2 pacientes (5,9%). En el resto de los pacientes se objetivaron 8 recurrencias (6,6%) (p = 0,8). Se produjeron 2 fallecimientos en el grupo de pacientes con síncope (5,9%) y 15 (12,3%) en el resto de la serie (p = 0,4). El riesgo relativo de recurrencia y/o muerte asociado al síncope fue de 0,5 (intervalo de confianza del 95%, 0,2-1,8). El riesgo fue similar despuÉs de ajustarlo a la presencia o ausencia de cáncer o de trombosis venosa profunda.

Conclusiones

Los pacientes con síncope como forma de presentación de la TEP no tienen un riesgo aumentado de recurrencia y/o muerte respecto al resto.

Palabras clave:

Tromboembolia de pulmón

Síncope

Recurrencia

Muerte

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REFERENCES

[1]

FA Anderson Jr, HB Wheeler, RJ Goldberg, DW Hosmer, NA Patwardhan, B Jovanovic, et al.

A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT study.

Arch Intern Med, 151 (1991), pp. 933-938

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